The anterior cruciate ligament (ACL) is the primary stabilizing ligament on the within of the knee. Its essential perform is to stop the tibia (shin bone) from sliding ahead and rotating on the femur (thigh bone). Tears/ruptures of the ligament end in knee instability.

Causes:

In an interview with HT Lifestyle, Dr Manu Bora, Knee Injury and ACL Surgery professional and Orthopedic Surgeon at Nexus Day Care Centre, shared, “ACL tears are typically caused by twisting or hyperextension injuries. Sports activities like pivoting or sudden deceleration when running and falls during skiing are considered non-contact causes of ACL tears. Direct trauma to the back or side of the knee during collision sports is considered a contact injury to the ACL.”

Symptoms:

Dr Manu Bora knowledgeable, “ACL tears cause immediate pain and often swelling. You may feel something “pop” contained in the knee. An preliminary incapability to bear weight on the leg could subside and strolling could also be potential after a number of minutes. The knee could really feel free or that it will “give out” and returning to sport is not possible. Over time, swelling will enhance and movement could also be misplaced.”

How is it recognized?

Revealing that your surgeon will carry out an intensive historical past and bodily examination with X-rays, Dr Manu Bora mentioned, “On exam, swelling and loss of motion and strength are present. Your surgeon will perform maneuvers to check the stability of all the knee ligaments and the meniscus. An MRI is helpful to confirm the diagnosis, showing the ACL tear. The type of tear (partial, complete, avulsion from either the tibia or femur) can be defined, which may assist in surgical planning. The MRI may also show bone bruising secondary to the injury.”

Treatments:

1. Non-operative – Dr Manu Bora defined, “ACL tears do not heal. Some patients elect not to have reconstruction surgery. Non-operative treatment increases the risk of “wear and tear” arthritis and meniscus tears due to the instability within the joint. Non-operative therapy consisting of anti-inflammatory medicine, bodily remedy, cryotherapy and exercise modification could also be prescribed previous to surgical procedure to lower the swelling, regain movement and power, as analysis has demonstrated that surgical procedure is easier and sufferers have higher outcomes. Non-operative therapy in surgical affected person could also be skipped if different accidents to the meniscus and cartilage are current and must be repaired instantly.”

2. Operative – According to the well being professional, “Operative management of ACL tears depends on the type of tear. ACL repair may be indicated in patients where the ACL is clearly torn off the wall of the femur (thigh bone) or tibia (shin bone. ACL repair is accomplished through a minimally-invasive arthroscopic procedure and sewed back into place and fixed with screws or buttons. The repair may also be supplemented with high-strength suture.”

Dr Manu Bora added, “If formal reconstruction is required, a new ACL graft will be fixed in place of the original ligament. A technique for graft placement and graft choice is a shared decision between you and your surgeon. Most techniques are performed through a minimally-invasive arthroscopic procedure. The graft can be taken from around your knee or from a donor. Postoperative rehabilitation, return to daily activities and return to sport depends on the technique and graft chosen and is at your surgeon’s discretion.”

3. Internal Brace Option – Highlighting that the Internal Brace process, which has been confirmed to be efficacious, could be utilized in numerous methods all through the knee, Dr Manu Bora mentioned, “This augmentation helps prevent excess range of motion during the healing phase and may reduce the chances of secondary injury. In the setting of ACL reconstruction, the Internal Brace procedure helps protect against various modes of failure including creep and irreversible stretch, traumatic tearing, and slippage of the tendon-bone interface. The Internal Brace technique may also help protect small and vulnerable ACL reconstruction grafts from these modes of failure.”